School nurses can you help me?

  1. I started nursing school full time this year so I am totally exhausted. I have 5 children too. Well this year the staff at my son's school are managing Austin's diabetes. Last year was his first year at the school (it is a private school) and they never took the time to find anything out. His teacher last year just talked to me and we worked everything out. Probably not the appropriate way to do things, but that's what we did last year and things were ok. This year, the secretary is unbelievably difficult, condescending, and critical. Austin's blood sugars have been swinging like you wouldn't believe and I have been a terrible time managing things. He's going from HI glucose (above 600) to 40s. I am trying my darndest to get everything under control, but I am not always reachable by phone. I understand the school's concern, but unfortunatley I cannot be up there at a moment's notice and they have been totally unhelpful about learning what to do to manage the highs and lows. Yesterday was the worst. I was flipped out completely. He had a blood sugar of 342 at 9:00am and by 10 something (sorry don't have the exact time in front of me he was 47. He dropped down to 23 and almost passed out in the school. This has never happened to us before in 5 years of dealing with diabetes 40s have been the lowest I have ever seen. The school couldn't get a hold of me because my cell phone doesn't work in all areas of the school. They were afraid to call 911! Gees oh petes, use some common sense if the kid looks like he is going to pass out err on the side of caution call 911. I would much rather have them call 911 then leave him there because they were unclear of what the meaning of "unresponsive" means. My husband eventually got up there. He is supposed to be going on a pump, but won't be able to start until October 23. I tried to explain to them that we can't just go on a pump right now that there is training that has to be done and it's just not that simple. I tried to explain to them that the pump will not fix his diabetes that it is only a treatment. Yes, it will help, but they will still have to deal with highs and lows and that yes, this might happen again. They can't understand that even though he is 10 he can't manage every aspect of his diabetes care. They don't seem to comprehend that even if he was an adult if he was that low he could not take care of himself. Well they sent this note home with my husband that said due to the inconsistencies with his blood sugars he cannot return to school until we have a note from his doctor explaining why his blood sugars are so inconsistent. I was so angry I could scream!!! I wanted to say it's called DIABETES!!! It's not the give 'em some insulin quick fix people like to believe. I am not a bad mom. I am doing the best I can with his blood sugars. He eats the same thing for breakfast and lunch every day. The secretary actually said this to my husband "You might have to homeschool him because even the public schools wouldn't put up with this" OMG!!!! Well I called the American Diabetes Association and they said if the school receives any public funding then they have to follow the guidelines for the public school and they cannot kick him out of school for diabetes. Well they do get funding. They get buses from the public schools, teacher consultants, and lunches. Apparently the public school nurse called them and is working on retraining them and educating them and I think she chewed them out, but I am so upset I want to just cry. I have been shaking. I am taking a heavy class load. I have waited 10 years to be able to do this. We have invested a lot of money in this. I can't just quit and I am angry that they expect me to. Diabetes shouldn't make me homebound. They should be able to learn. They don't want to learn to treat this. They want me to come up there every time his blood sugar is out of range. I am so frustrated. Can any of you help me with resources or anything with my son's rights and their expectations as well as what is reasonable to expect from me. Thanks so much!

    Last edit by TeresaRN2b on Sep 11, '03
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    About TeresaRN2b

    Joined: Jun '01; Posts: 564; Likes: 2


  3. by   bergren

    How much has your doctor gotten involved? This situation is totally unacceptable and I would get in touch with the Juvenile Diabetes Association too. Thanks goodness the school nurse has gotten involved.

    Keep us informed.
  4. by   MomNRN
    Do they not have a nurse at your son's private school? If not, I wonder whether you want the secretary to really be in charge of monitoring your son's diabetes.

    In our public schools, the school nurses are assigned two schools so they are not in the building every hour of the day. Dispensing meds and medical advice falls on the teacher and the principal, not the secretary. I would be leery of having a layperson (such as the secretary) knowing what to do with fluctuating blood sugars.

    You need to find a reliable, intelligent contact person at your son's school to be in charge. I suggest the teacher. If they are not trained properly or willing to make the commitment, it could have drastic results.

    While I agree that you should not be homebound just because of diabetes, you need to advocate for a better solution for Austin. If the teacher is not willing, perhaps you do need to look to the public schools. If the public schools have available nurses, perhaps that is the answer.

    My daughter's school is great at assisting several children with diabetes, but I know of other schools which aren't. For some reason, some principals get really freaked knowing they have a diabetic child in the building. Educating the staff and the public can be a huge task!

    Good luck to you. I am interested in hearing how it turns out for you.
  5. by   SnowieRN
    Is there a reason you dont want him public schooled? It saves money and its more fun for him, and public schools would probally know how to deal with it. We didnt have a nurse at our school but we had a EMT-P on site 1 hour before and after school hours.

    I think you could probally sue for wrongfully discharging him from school. I also wonder what kind of people are running that place.. if someone passes out on the floor what do they do? Poke him with a stick until he wakes up?
  6. by   TeresaRN2b
    Yes, there is a reason I don't want him in public school. The school we are zoned for is awful. Ranking one of the lowest in the state for academic testing. He is dyslexic and was literally not reading in the 4th grade when I threw in the towel and came up with the money for private school. He has already made remarkable improvements there and made friends there which he had not in the school he was in before. His old school was awful and he hated it. I will not send him back there. Also in the public school there is only one nurse for the entire district which is rather large so they basically trained the staff for his diabetes care. The public school nurse has advocated in his behalf and will be training the school so I feel much better than I did when I originally posted. Thanks for your input.

  7. by   cpgrn
    I don't know if this applies to private schools or not, but there is IDEA and the disability act. I think this sounds illegal and would never be tolerated in the public school where I work. There are lawyers who specialize in people with disabilities. If it were my child, I would be checking into it.
  8. by   kids
    Originally posted by cpgrn
    I don't know if this applies to private schools or not, but there is IDEA and the disability act. I think this sounds illegal and would never be tolerated in the public school where I work. There are lawyers who specialize in people with disabilities. If it were my child, I would be checking into it.
    Good lord! I realize that diabetes can be difficult to manage but does anyone else get a sick feeling about this schools ability to handle a bee sting?

    You have said the school receives public funds so the Federal laws apply.

    Your son is covered by the American's with Disabilities Act. The school is required to develope and provide a 504 plan. Unfortunately this is not going to give you a quick fix but it is still something he will still need in place after the pump is placed.

    Contact his Pediatrician or Endocrinologist, ask him to put in writing your son's S/S of hypo/hyper glycemia and the EXACT steps they are to take for any give CBG range.
  9. by   Jeanine
    Oh my GOODNESS!!! You need to have yourself of your husband go into that school with a lawyer! Before you do that, ask the principal to gather the staff for an in-service either before or after school. It sounds like they're scared to death of your son's diabetes and it's probably because they're ignorant of the disease process, it's s/s, and it's treatment. Ask your diabetes nurse educator to either give the staff an in-service, or give you materials that she would use with a family that is new to the disease and you give it to the staff. You work in a school, you know how teachers can get. It's the same way we school nurses get in our first experiences teaching. Fear and inaction because of ignorance could do your son irreperable harm! Good luck!
  10. by   smk1
    hi just wanted to say that i worked as a school health assistant for 3 years prior to being a stay at home mom and i am APPALLED reading this! there is no excuse for the staff to behave this way. Even if they do not know the s/s and dangers of hyper/hypoglycemia they should be competent enought to read directions! please please have your doctor or the rn at the doctors office draw up a care plan (or if you have one for home use it) this helps enormously. ie: blood sugars between #-# do this if between #-# do that. having a set plan of action for the staff may relax them. Oh and at least where i worked ems didn't charge for coming out to assess, they only charged if they transported and if they transported then obviously they needed to be called. This helped me feel a bit more relaxed about calling for help if i thought it was needed. If the public school nurse is going to help then i imagine the situation will get better. One thing i would do is talk to the teacher and make sure that his testing times remain the same everyday.
  11. by   smk1
    a side note but just wanted to say that school nurses sometimes don't get the credit that they deserve. the reason i am in school now to becaome a nurse is because of one that i worked with. she was so concerned about the dental health of some of the poorer students that she contacted nw medical teams and was able to get a program started for free dental care via a mobile dental van going throughout the county. kids who needed fillings or rotten teeth to be pulled etc. were able to go back to school without mouth pain and concentrate on their work. this program has expanded to include students throughout the city of all ages. she was and still is an inspiration to me.